Provider Demographics
NPI:1295837011
Name:MILLER, STEVEN M (DDS)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:M
Last Name:MILLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12788 W FOREST HILL BLVD
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4703
Mailing Address - Country:US
Mailing Address - Phone:561-798-8023
Mailing Address - Fax:561-791-8802
Practice Address - Street 1:12788 W FOREST HILL BLVD
Practice Address - Street 2:SUITE 2001
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4703
Practice Address - Country:US
Practice Address - Phone:561-798-8023
Practice Address - Fax:561-791-8802
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN0010350122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist